WAL-MART STORES TEXAS, LLC (NPI# 1912088352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912088352 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES TEXAS, LLC |
| Other Organization Name | WAL-MART VISION CENTER 30-1022 |
| Practice Address |
3820 Highway 64 W Tyler TX 75704-6924 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 9035972888 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-05-29 |
| Authorized Official Name | LAURA LEVINE (MANAGER GOV CONTRACTING) |
| Authorized Official Telephone | 4792048550 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAL-AMRT STORES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Wal-Mart Vision Center 30-1022 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194216143 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 26824 Fm 1093, Richmond, TX 77406 | 2018-05-25 |
| 1528555463 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 7831 Paseo Del Norte Blvd, Ste A, El Paso, TX 79912 | 2018-04-17 |
| 1619470770 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 5336 Golden Triangle Blvd, Fort Worth, TX 76244-4406 | 2018-03-15 |
| 1275067977 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 1951 Military Parkway, Mesquite, TX 75149 | 2017-04-19 |
| 1225578529 | Wal-mart Stores Texas, LLC | Technician/Technologist | 22850 Morton Rach Rd, Katy, TX 77449 | 2017-03-06 |
| 1912445487 | Wal-mart Stores Texas, LLC | Technician/Technologist | 1151 Us Hwy 90 E, Castroville, TX 78009 | 2017-02-06 |
| 1992256325 | Wal-mart Stores Texas, LLC | Technician/Technologist | 25800 Kuykendahl Road, Tomball, TX 77375 | 2016-10-20 |
| 1699123893 | Wal-mart Stores Texas, LLC | Technician/Technologist | 510 Kitty Hawk Rd, Universal City, TX 78148-3961 | 2016-05-27 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1144680539 | Wal-mart Stores Texas, LLC | Technician/Technologist | 2901 Riley Fuzzell Road, Spring, TX 77386 | 2016-02-29 |
| Street Address |
3820 HIGHWAY 64 W |
| City | TYLER |
| State | TX |
| Zip Code | 75704-6924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961912 | Ankit Gohel | Pharmacist | 3820 Highway 64 W, Tyler, TX 75704-6924 | 2020-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194325415 | Rupal R Patel | Pharmacist | 3820 Tx 64, Tyler, TX 75704 | 2020-10-27 |
| 1932757945 | Gracelyn Hernandez Kuester | Technician | 14320 Country Road 420, Tyler, TX 75704 | 2019-09-03 |
| 1033770227 | Rajamanoj Kondaveeti | Dentist | 3873 Tx-64, Tyler, TX 75704 | 2019-06-27 |
| 1063070209 | Susan Michele Whitaker | Counselor | The Beginning, 114 Jordan Plaza Blvd Suite 302, Tyler, TX 75704 | 2019-06-03 |
| 1649836768 | Tyla Sherrie' Tarrant | Licensed Vocational Nurse | 3050 Cr 427, #502, Tyler, TX 75704 | 2019-05-14 |
| 1437458874 | North Mesa Dental, PC | Dentist | 3864 Hwy 64 West, Tyler, TX 75704 | 2011-03-24 |
| 1093025751 | Zana Elliot Enterprises LLC | Nurse Practitioner | 12751 Westbrook Dr, Tyler, TX 75704 | 2010-10-15 |
| 1710036454 | Tammy Jimenez | Dietitian, Registered | 5555 W. Twin Lakes Dr., Tyler, TX 75704 | 2007-01-10 |
| 1063023935 | Shanika Lanell Grant | Licensed Vocational Nurse | 134 Patton Ln, Tyler, TX 75704-2004 | 2020-08-13 |
| 1194342410 | Shanequia Dianne Flowers | Licensed Vocational Nurse | 404 Lemay Dr, Tyler, TX 75704-2031 | 2020-07-02 |
| Find all providers in zip 75704 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508180928 | New Columbian Optical Company | Eyewear Supplier (Equipment, not the service) | 2105 S Broadway Ave, Tyler, TX 75701-4214 | 2010-03-15 |
| 1356490650 | Ragsdale & Martin Optical, Inc | Eyewear Supplier (Equipment, not the service) | 2740 S Broadway Ave, Tyler, TX 75701-5412 | 2007-01-09 |
| 1427114941 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 4701 S Broadway, Broadway Square Mall, Tyler, TX 75703-1309 | 2006-12-29 |
| 1780776641 | Eyemasters of Texas, Ltd | Eyewear Supplier (Equipment, not the service) | 701 W Sw Loop 323, Tyler, TX 75701-9410 | 2006-09-29 |
| 1518988609 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 4401 S Broadway Ave, Tyler, TX 75703-1304 | 2006-07-22 |
| 1174558894 | Tyler Optical Lab Inc | Eyewear Supplier (Equipment, not the service) | 4568 S. Broadway Ave., Tyler, TX 75703-1305 | 2006-07-11 |
| 1124545413 | Charles L. Heaton, M.d. P.a. | Eyewear Supplier (Equipment, not the service) | 3415 Golden Rd, Tyler, TX 75701-8355 | 2017-08-28 |
| 1326599390 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 7003 S Broadway Ave, Tyler, TX 75703-4737 | 2016-10-14 |
| 1003214040 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 4826 S Broadway Ave, Tyler, TX 75703-1312 | 2014-12-08 |
| 1417225772 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 701 W Sw Loop 323, Tyler, TX 75701-9410 | 2011-12-01 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.